NPI | 1679933154 |
---|---|
Doing Business As | SURPRISE FAMILY DENTISTRY |
Entity Type | Organization |
Authorized Contact | SHREEDEVI THULASIDAS Dentist 623-556-5510 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: AZ D05975) |
Additional Taxonomies | 122300000X Dentist (Licence: AZ D07677) |
1223G0001X Dentist, General Practice (Licence: AZ D07677) | |
1223G0001X Dentist, General Practice (Licence: AZ D05975) | |
1223P0700X Dentist, Prosthodontics (Licence: AZ D07677) | |
Enumeration Date | 2016-02-26 |
Last Update Date | 2016-11-01 |